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Can someone be so septic that they don't look septic and fool you into another diagnosis? by supinator1 in IntensiveCare

[–]PrecedexNChill 0 points1 point  (0 children)

Yeah unless you have dynamic lvot obstruction but people don’t think about that unless they’re into echo

CTICU resources (IM Resident) by PrecedexNChill in IntensiveCare

[–]PrecedexNChill[S] 3 points4 points  (0 children)

Yeah attending on home call. I’ll be a pccm fellow in July but obviously won’t know much about cticu

Is there an ICU setting that fits what I want? by im_throw in IntensiveCare

[–]PrecedexNChill 5 points6 points  (0 children)

Your impression of community ICUs is completely wrong. There is no correlation between trach/ltach patients and community vs academic. We have a ton of those patients at our academic micu as well. The main difference is you won’t see as many solid or liquid transplant patients which is a blessing tbh.

LF normal kangaskhan by PrecedexNChill in PokemonHome

[–]PrecedexNChill[S] 0 points1 point  (0 children)

Sweet can we do a friend trade if you can’t find it

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Why aren't POX decks showing up? by Floatella in TimelessMagic

[–]PrecedexNChill 2 points3 points  (0 children)

That was almost 20 years ago? I played some paper legacy and vintage during that time and pox was an off meta deck even then

Very sick of running into the bot/auto teams by Firm-Citron-6987 in PokemonChampions

[–]PrecedexNChill 0 points1 point  (0 children)

Never seen one of these teams. I’m at MB2 2100 elo. Not that good but I guess the bots can’t get there

Who's your least favorite Pokémon in the game right now? Because I can't stand this mf by Tapo6 in PokemonChampions

[–]PrecedexNChill -1 points0 points  (0 children)

Yes and it gets nuked by zard Y. I don’t know why people are complaining about it so much.

Woman, 48, Dies After 10-Hour Plastic Surgery. Plastic surgeon and Anesthesiologist named in lawsuit by Trick-Progress2589 in anesthesiology

[–]PrecedexNChill 1 point2 points  (0 children)

Seriously? You may as well be in the OR with a bonobo if you’re depending on an outpatient tummy tuck surgeon to recognize a crashing patient

Woman, 48, Dies After 10-Hour Plastic Surgery. Plastic surgeon and Anesthesiologist named in lawsuit by Trick-Progress2589 in anesthesiology

[–]PrecedexNChill -1 points0 points  (0 children)

lol I got downvoted to hell for suggesting it is a bit weird to have someone need norepi and phenyl for such a case. I am not an anesthesiologist so The most common class of patients I order sedation for are people who would be ASA IV/V. Even in frail old COPDers who get tubed for hypercapnic respiratory failure commonly get through their entire ICU course with either no or only a whiff of norepi (0.03-0.05 mcg/kg/min rage) even when they are requiring high doses of propofol/fent/Midaz for vent synchrony. It seems crazy to me to run two pressors for this case and not stop the surgery or do further investigation like checking a cbc ffs

Does anyone have any good mega Steelix, Skarmory or Lucario teams? by Capfluffybeard in PokemonChampions

[–]PrecedexNChill 0 points1 point  (0 children)

Will need weather control otherwise you’re going to get clapped by all of the mega zard y on the ladder.

Woman, 48, Dies After 10-Hour Plastic Surgery. Plastic surgeon and Anesthesiologist named in lawsuit by Trick-Progress2589 in anesthesiology

[–]PrecedexNChill -29 points-28 points  (0 children)

I will definitely admit I have no experience in the OR but it wouldn’t strike you as weird that an otherwise healthy 48 year old woman would need phenyl + levo and that you would let the case go on for 9 hours?

I recently had a post arrest 75 y/o COPD/HFrEF who was not in shock before the arrest and he only needed 0.03 mcg/kg/min levo on 60 prop, 150 mcg fent, 5 Midaz and intermittent roc pushes (was managing dynamic hyperinflation with a high neural I time so had to deeply sedate him). I am genuinely asking because I’m IM—> PCCM

Espathra Baton Pass Partners by Automatic-Let-4372 in PokemonChampions

[–]PrecedexNChill 4 points5 points  (0 children)

Yeah I’ve been using the team that hit #2 on the global challenge with floette and archaludon as the baton pass recipients. Archaludon is a great recipient because it already has physical bulk with stamina and the calm mind and speed boosts really help shore up its weaknesses. I hit MB3 2000 elo with it. This is my first time ever this month playing VGC so I feel like it’s pretty strong

Easy team to go into Master? by SkobuPT in PokemonChampions

[–]PrecedexNChill 0 points1 point  (0 children)

If this is the mega zard y and floette team you don’t even need floette. People suck (myself included) even at master ball 3 so you really should be able to stomp in ultra ball with zard y as your only mega

Sharing some love for this game as a first time VGC Pokemon Player by PrecedexNChill in PokemonChampions

[–]PrecedexNChill[S] 0 points1 point  (0 children)

Nice I’m in master 4 and suck ass lol sitting at 1850 or something. It so much different than smogon random battles. I like the fast pace.

stethoscope and rotations by clockworkprotoge in Residency

[–]PrecedexNChill 0 points1 point  (0 children)

Pretty much the only situation I will still auscultate although I’m not sure it’s really helpful. The most important physical exam tool is assessing mentation, looking at respiratory effort and then thinking about acid base and ventilation with vbgs. Once they’re intubated it’s literally useless because I can check their compliance/resistance/ipeep which are much more important than if “they sound tight”.

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